HYPOKALEMIA FROM A NOREPINEPHRINE INFUSIO N

We report a case of a severe hypokalaemia by intracellular shift of po tassium in a sedated and ventilated head trauma patient. The kalaemia which was 3.9 mmol . L(-1) at admission in the intensive care unit dec reased to 1.3 mmol . L(-1) during a perfusion of noradrenaline (0.3 mu g . kg(-1). min(-1)). Following the decrease of the noradrenaline dos e, and administration of potassium, the kalaemia rapidly increased to 5.3 mmol . L(-1) carrying a risk of arrhythmia. Therefore, kalaemia an d ECG should be closely monitored when the noradrenaline doses are red uced. The causes of transcellular shift of potassium are reviewed.